CRAT Pacemaker Rhythm Analysis 3

Question 1

What is pacemaker syndrome?

Accepted Answer

Symptoms from loss of AV synchrony in VVI pacing, causing retrograde atrial contraction against closed mitral valve

Answer

Battery depletion causing pacemaker failure

Answer

Electromagnetic interference inhibiting pacing

Answer

Pacemaker lead fracture causing intermittent loss of capture

Question 2

Rate response (R) in pacemaker programming allows the device to do which of the following?

Accepted Answer

Increase pacing rate in response to physical activity by detecting body movement or minute ventilation

Answer

Pace faster during ventricular arrhythmias

Answer

Automatically switch from VVI to DDD mode

Answer

Extend battery life by slowing the pacing rate

Question 3

Which intervention should be attempted first for a pacemaker patient presenting with failure to capture?

Accepted Answer

Increase pacing output amplitude on the programmer or apply a magnet to evaluate threshold

Answer

Immediate surgical lead revision

Answer

IV epinephrine infusion

Answer

Synchronized cardioversion

Question 4

In a patient with a permanent pacemaker, a magnet applied over the pulse generator typically causes what pacemaker behavior?

Accepted Answer

Asynchronous pacing at a fixed rate (magnet rate), ignoring sensed cardiac activity

Answer

Complete pacemaker inhibition

Answer

Rate-adaptive mode activation

Answer

Battery level testing only

Question 5

Pacemaker-mediated tachycardia (PMT) can occur in dual-chamber pacemakers due to which mechanism?

Accepted Answer

Retrograde P waves are sensed by the atrial channel, triggering ventricular pacing, creating a reentrant loop

Answer

The pacemaker spontaneously increases its own rate

Answer

Battery depletion causes rapid pacing

Answer

Undersensing of ventricular complexes

Question 6

Which lead position is used for most right ventricular apical pacing, and what ECG pattern does it produce?

Accepted Answer

Right ventricular apex, producing a left bundle branch block (LBBB) pattern with left axis deviation

Answer

Right ventricular outflow tract, producing a right bundle branch block pattern

Answer

Left ventricular free wall, producing a narrow QRS

Answer

Coronary sinus, producing a narrow QRS complex